Muscle–tendon arrangement and innervation pattern of the m. flexor digitorum superficialis in the common marmoset (Callithrix jacchus), squirrel monkey (Saimiri sciureus) and spider monkey (Ateles sp.)

The muscle–tendon arrangement of the m. flexor digitorum superficialis (FDS) varies among different primate groups. Recent developmental investigations revealed that the primordium of FDS emerges in the hand region first and relocates to the forearm later. The relationship between the diverse muscle–tendon arrangement and the characteristic developmental process of FDS is important for understanding the evolutionary changes of the FDS. Moreover, the innervation pattern cannot go unremarked when discussing the muscle homology and evolution. We examined the muscle–tendon arrangement and intramuscular nerve distribution of the FDS in three genera of Platyrrhini: three common marmosets (Callithrix jacchus), two squirrel monkeys (Saimiri sciureus) and two spider monkeys (Ateles sp.). We observed that the FDS consisted of multiple muscle bellies. The origin of the muscle bellies to digits II and V varied, whereas muscle bellies to digits III and IV consistently originated from the medial epicondyle. The muscle–tendon arrangement of the FDS differed among the three genera owing to the different origins of muscle bellies to digits II and V. In all the examined specimens, the muscle bellies to digits II and/or III were innervated by the direct nerve branches from the median nerve. However, the muscle bellies to digits IV and V never received direct nerve branches from the median nerve. Nerve branches within the belly to digit III extended into the belly to digit IV, and one nerve branch within the belly to digit IV extended into the belly to digit V. These consistent nerve distribution patterns suggest that different patterns of FDS muscle–tendon arrangement have changed from that of a common ancestral condition. It is plausible that the diverse origins of muscle bellies in the FDS are attributable to the difference in the destination for the relocation of the muscle bellies during developmental processes.     

Replacement costs of cold storage equipment for medical products of public healthcare establishments of European Union countries

This study presents a quantification of the financial needs to maintain the stock of cold equipment for the preservation of medical products in public health care establishments of European Union (EU) countries. The conditions that must be guaranteed, the types of equipment used, the installed capacity, the total annual financial needs and the estimate of its evolution in the near future are addressed.A field survey involving Portuguese establishments of various types and dimensions was performed in order to assess the currently installed volume by type of equipment.Through an analysis based on possible scenarios and using a methodology considered adequate, the financial needs to maintain such equipment in operation was estimated for Portugal, for each EU country and for the EU as a whole. The economic value of these amounts in 2017 and following years was obtained assuming the average price of each type of equipment and considering an expected evolution of its value.     

人工牙排列位置对下颌全口义齿固位及支持组织的影响

采用ＣＴ－数字化仪－ＣＡＤ系统建立了下颌无牙颌骨及其义齿的３个三维有限元模型，探讨在Ｈｅ力，口周肌力作用下，下颌人工牙排列位置对义齿固位和支持组织应力分布的影响，并测量了１０例口周肌动力及传统型全口义 工牙排列位置的差异。结果表明；Ｈｅ力作用下，人工牙排列干剩余牙槽嵴顶及水平偏离槽嵴顶舌，颊侧３ｍｍ，对牙骨应力分布无明显影响，但后牙位于下颌骨外斜嵴区对支持组织有利；正中Ｈｅ时，磨牙排列于牙槽嵴顶颊     

Cost comparison of laparoscopic versus robot-assisted radical cystectomy

Purpose

Minimally invasive techniques have had an increasing implementation trend in recent years but they are associated with significantly higher costs.

武汉社区老年人居住方式与认知功能关系

目的探讨社区老年人居住方式与认知功能障碍的关系。方法采用现况研究、系统抽样方法,于2014年8月—2016年8月在湖北省武汉市武昌区4个社区共调查了1 818名老年人,以蒙特利尔认知评估量表评分作为认知功能的评价指标,数据分析采用χ2检验、方差分析、SNK检验和多因素非条件logistic回归。结果仅与配偶居住、与配偶/子女居住是老年人认知功能的保护因素(OR=0.57,95%CI=0.41~0.79;OR=0.66,95%CI=0.45~0.98)。调整年龄、性别、教育程度、职业、锻炼、吸烟饮酒、社会网络(规模、复杂性)后,OR=0.62,95%CI=0.45~0.88;OR=0.73,95%CI=0.46~0.98。结论老年人的认知功能与居住方式有关,与配偶居住能减缓认知功能的损伤。     

我国婴幼儿睡床方式及其对睡眠结局影响的研究

目的 了解我国婴幼儿睡床方式现状、影响因素及其对睡眠结局的影响。方法 于2012-2013年按照“省-市-县-医院”的抽样技术路线,抽取全国8省市1 304名0~35月龄足月、健康婴幼儿作为研究对象。通过家长填写《简明婴幼儿睡眠问卷》( BISQ)和自编《儿童个人及家庭社会环境问卷》了解婴幼儿睡床方式、睡眠模式及人口统计学因素。结果 婴幼儿平均为(12±10)月龄,男婴占53.8%。婴幼儿与父母同床睡的比例高达84.8%,同房睡为13.2%,独立睡为2.0%。相比6月龄以下婴幼儿,≥6月龄同床睡比例显著较高,同房睡显著较低(P均<0.05),而独立睡无组间差异(P>0.05)。多因素Logistic回归分析显示,婴幼儿年龄≥6月龄、家庭人均月收入≤3 000元和居住郊区是同床睡的风险因素。一般线性回归分析显示,在矫正混杂因素后,同床睡对所有睡眠结局参数的预测作用均不显著(P均＞0.05)。结论 同床睡是我国0~35月龄婴幼儿最常见的睡床方式,发生率远高于欧美国家,与婴幼儿月龄和社会经济状况相关,但未发现其对睡眠结局有直接影响。     

护理排班模式改革探讨

目的　探讨高效、全程优质服务的护理排班模式。方法　在原有人力基础上 ,改变人力结构 ,实施全夜制 (9PM～ 9AM ) ,2 4h分 3个班次 ,并增设护理骨干值二线班。结果　与传统式比较 ,护士交班、书写次数明显减少 ,抢救病人成功率从 2 5 %提高到 67% ,病人满意度从 94.5 %提高到 10 0 % (P <0 .0 5 )。结论　护理排班模式改革后 ,加强了中午、晚上的薄弱环节 ,为抢救赢得了时间 ,护士业务方面又起到互补互相促进作用     

经典名方当归四逆汤的药物剂量考证

目的 通过系统整理经典名方当归四逆汤的中医古代文献,梳理当归四逆汤的药物剂量演变,试确定当归四逆汤的适宜剂量,使其更适合临床实际应用,也为该方的新药开发提供一定的参考。方法 采用文献计量学方法,对记载当归四逆汤药物剂量的文献资料进行分析,考证当归四逆汤的原书剂量、历代用量演变、药物剂量比例及近现代名医的使用情况。结果 经文献考证,发现当归四逆汤药物使用剂量经历由大变小的过程,并根据当归四逆汤的用量演变规律,推算东汉1两约为现今3 g。且历代医家在运用当归四逆汤时,当归、桂枝、白芍、细辛、通草、甘草的配伍比例多取3∶3∶3∶3∶2∶2。结论 建议当归四逆汤汤剂的药物剂量为当归9 g、桂枝9 g、白芍9 g、细辛9 g、木通6 g、甘草6 g、大枣4枚,日服3次;煮散剂的药物剂量为当归4.5 g、桂枝4.5 g、白芍4.5 g、细辛4.5 g、木通3 g、甘草3 g、大枣2枚。     

城市社区卫生服务规范内容和支持条件的研究

鉴于中国广阔的地域和其社区卫生服务发展不均衡及服务内容不规范等问题,该文对我国目前社区卫生服务的规范内容和社区卫生服务在社会功能、经济补偿机制、全科医生培养等支持条件方面进行了探讨。